胸腹水细胞学前检查各环节因素分析  

Analysis of pre-examination factors affecting the detection of hydrothorax and ascites effusion

作　　者：郭建华[1] 张吉才[1] 李晓强[1] 伍亚云[2] 吴玉竹[1] 颜宏华 

机构地区：[1]湖北医药学院附属太和医院检验部,湖北十堰442000 [2]湖北十堰市红十字医院检验科442000 [3]湖北竹溪县人民医院检验科,湖北十堰442300

出　　处：《国际检验医学杂志》2012年第3期315-317,共3页International Journal of Laboratory Medicine

摘　　要：目的提高胸腹水肿瘤细胞阳性检出率,保证其诊断准确性。方法收集我院2010年3～7月住院患者的胸腹水94例(血性30、淡黄色64),在细胞学检查前,对每份标本制片前(放置时间、放置温度、离心速度与时间,不同样本涂片时的吸取方式等)的各个环节进行分析。结果 1.血性及淡黄色胸腹水在不同放置温度(4℃、20℃)、放置时间(30min、60min、离心速度3000r/min10min)时,其细胞变异率无显著差异,P>0.05.在放置120min、20℃时,其细胞变异率有显著差异,P<0.05。2.血性及淡黄色胸腹水在2000r/min10min、2000r/min20min,3000r/min10min、3000r/min20min,4000r/min10min时,其细胞变异率无显著差异,P>0.05;在4000r/min20min时,其细胞变异率与4000r/min10min时有显著差异,P<0.05。血性及淡黄色胸腹水之间无差异,P>0.05。3.血性胸腹水红细胞底层与上层的有核细胞数,有非常显著性差异,P<0.01;细胞变异率无显著性差异,P>0.05;肿瘤细胞检出率有非常显著性差异,P<0.01。4.在相同放置时间时,血性与淡黄色胸腹水的肿瘤细胞检出率无显著性差异,P>0.05;血性胸腹水放置30min与120min比较,其肿瘤细胞检出率有非常显著性差异,P<0.01;淡黄色胸腹水放置30min与120min比较,其肿瘤细胞检出率有非常显著性差异,P<0.01。结论为提高胸腹水细胞学阳性检出率及诊断准确性,降低漏诊、误诊率,细胞学检查前各环节的质量控制是非常重要的。Objective To improve the positive rate and accuracy for the detection of tumor cells in hydrothorax and ascites effusion.Methods 94 cases of hydrothorax or ascites effusion were collected from hospitalized patients between March and September 2010, among which 30 cases were bloody samples and 64 cases were yellow samples. Before cytology analysis, each specimen was grouped according to different storage time and temperature, different centrifugation speed and time, and different stain method.Results 1.There was no statistical difference of the detected results of bloody or yellow samples between groups with different storage temperature（4 or 20 ℃）,different storage time（30 or 60 min）, when the samples were centrifuged at 3 000 r/min for 10 min （P〉0.05）. There was significant difference of cell variation rates, when samples were stored at 20℃ for 120 min （P〉0.05）.2.There was no statistical difference of cell variation rates of between bloody and yellow samples, when being centrifuged at 2 000 r/min for 10 min, 2 000 r/min for 20 min,3 000 r/min for 10 min, 3 000 r/min for 20 min or 4 000 r/min for 10 min （P〉0.05）, but there was significant difference, when the samples were centrifuged at 4 000 r/min for 20 min. 3.The difference of nucleated cell numbers and the positive rate of tumor cells in red cell bottom and upper layer of bloody samples were significant（P〈0.01）, but that of cell variation rates was not significant（P〉0.05）. 4.There was no statistical difference of the detection rates of tumor cells between bloody and yellow samples, when being stored for the same time（P〉0.05）. There was significant difference of the detection rates of tumor cells in bloody or yellow samples, when being stored for 30 or 120 min （P〈0.01）.Conclusion Quality control of every pre-examination factors, affecting the cytology analysis of hydrothorax and ascites effusion, might be important for improving the positive detection rate and accuracy of diagnosis and decreasing the rate o

关 键 词：胸腹水 细胞学检查前 诊断 因素分析 统计学 

分 类 号：R446.8[医药卫生—诊断学]